Contact lenses and dry eye syndrome: can they be reconciled?

The function of the tear film is to moisturize, lubricate, nourish, and protect the delicate surfaces of the cornea and conjunctival epithelium covering the eyeball and eyelids. A healthy tear film is crucial for shaping and maintaining a smooth refractive surface of the cornea, ensuring proper optical function of the eye by eliminating small irregularities in the epithelium. Contact lens wearers often experience various discomforts related to wearing lenses, known as contact lens discomfort (CLD), which can lead to discontinuation of lens wear. CLD is frequently associated with dry eye disease, caused by tear film disorders resulting from incorrect composition, reduced production, or excessive evaporation of tears from the ocular surface. Contact lens wear can diminish corneal sensitivity and lead to a reflex blockade of sensation, causing a deficiency in the aqueous layer of the tear film. Additionally, wearing contact lenses may increase tear evaporation due to reduced blinking frequency and incomplete eyelid closure during blinking. This paper discusses therapeutic approaches and modifications in lens fitting aimed at maintaining a healthy ocular surface and improving comfort for contact lens wearers.